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Paved with good intentions: Do public health and human service providers contribute to racial/ethnic disparities in health?

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  • Van Ryn, M.
  • Fu, S.S.

Abstract

There is extensive evidence of racial/ethnic disparities in receipt of health care. The potential contribution of provider behavior to such disparities has remained largely unexplored. Do health and human service providers behave in ways that contribute to systematic inequities in care and outcomes? If so, why does this occur? The authors build on existing evidence to provide an integrated, coherent, and sound approach to research on providers' contributions to racial/ ethnic disparities. They review the evidence regarding provider contributions to disparities in outcomes and describe a causal model representing an integrated set of hypothesized mechanisms through which health care providers' behaviors may contribute to these disparities.

Suggested Citation

  • Van Ryn, M. & Fu, S.S., 2003. "Paved with good intentions: Do public health and human service providers contribute to racial/ethnic disparities in health?," American Journal of Public Health, American Public Health Association, vol. 93(2), pages 248-255.
    • Handle: RePEc:aph:ajpbhl:2003:93:2:248-255_9
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    1. Hideyo Tsumura & Wei Pan & Debra Brandon, 2024. "Exploring Differences in Intraoperative Medication Use Between African American and Non-Hispanic White Patients During General Anesthesia: Retrospective Observational Cohort Study," Clinical Nursing Research, , vol. 33(6), pages 470-480, July.
    2. Varcoe, Colleen & Browne, Annette J. & Wong, Sabrina & Smye, Victoria L., 2009. "Harms and benefits: Collecting ethnicity data in a clinical context," Social Science & Medicine, Elsevier, vol. 68(9), pages 1659-1666, May.
    3. Horton, Sarah, 2006. "The double burden on safety net providers: Placing health disparities in the context of the privatization of health care in the US," Social Science & Medicine, Elsevier, vol. 63(10), pages 2702-2714, November.
    4. Mattarozzi, Katia & Colonnello, Valentina & De Gioia, Francesco & Todorov, Alexander, 2017. "I care, even after the first impression: Facial appearance-based evaluations in healthcare context," Social Science & Medicine, Elsevier, vol. 182(C), pages 68-72.
    5. Jones, Rhys G. & Trivedi, Amal N. & Ayanian, John Z., 2010. "Factors influencing the effectiveness of interventions to reduce racial and ethnic disparities in health care," Social Science & Medicine, Elsevier, vol. 70(3), pages 337-341, February.
    6. Came, H. & Doole, C. & McKenna, B. & McCreanor, T., 2018. "Institutional racism in public health contracting: Findings of a nationwide survey from New Zealand," Social Science & Medicine, Elsevier, vol. 199(C), pages 132-139.
    7. Louie, Patricia & Wilkes, Rima, 2018. "Representations of race and skin tone in medical textbook imagery," Social Science & Medicine, Elsevier, vol. 202(C), pages 38-42.
    8. Bagnis, Arianna & Caffo, Ernesto & Cipolli, Carlo & De Palma, Alessandra & Farina, Gabriele & Mattarozzi, Katia, 2020. "Judging health care priority in emergency situations: Patient facial appearance matters," Social Science & Medicine, Elsevier, vol. 260(C).
    9. Burgess, Diana Jill & Crowley-Matoka, Megan & Phelan, Sean & Dovidio, John F. & Kerns, Robert & Roth, Craig & Saha, Somnath & van Ryn, Michelle, 2008. "Patient race and physicians' decisions to prescribe opioids for chronic low back pain," Social Science & Medicine, Elsevier, vol. 67(11), pages 1852-1860, December.
    10. Parish, Susan L. & Rose, Roderick A. & Andrews, Megan E. & Shattuck, Paul T., 2009. "Receipt of professional care coordination among families raising children with special health care needs: A multilevel analysis of state policy needs," Children and Youth Services Review, Elsevier, vol. 31(1), pages 63-70, January.
    11. Meeuwesen, Ludwien & Harmsen, Johannes A.M. & Bernsen, Roos M.D. & Bruijnzeels, Marc A., 2006. "Do Dutch doctors communicate differently with immigrant patients than with Dutch patients?," Social Science & Medicine, Elsevier, vol. 63(9), pages 2407-2417, November.
    12. Felix C.H. Gottschalk, 2019. "Why prevent when it does not pay? Prevention when health services are credence goods," Health Economics, John Wiley & Sons, Ltd., vol. 28(5), pages 693-709, May.
    13. Ahn, Haksoon & Xu, Yanfeng & Williams, Kimberly A. & Parks-Bourn, Kimberly & Williams, Syreeta & Conway, Denise, 2022. "Family team decision meeting and child welfare service disparities: The influence of race and poverty," Children and Youth Services Review, Elsevier, vol. 143(C).
    14. McCabe, Katharine, 2016. "Mothercraft: Birth work and the making of neoliberal mothers," Social Science & Medicine, Elsevier, vol. 162(C), pages 177-184.
    15. Anand Chand & Suwastika Naidu, 2017. "Health Care Service Quality and Availability of Skilled Health Workforce: A Panel Data Modelling of the UK, USA and Israel," Modern Applied Science, Canadian Center of Science and Education, vol. 11(10), pages 152-152, October.
    16. Kahn, Nicholas E. & Hansen, Mary Eschelbach, 2017. "Measuring racial disparities in foster care placement: A case study of Texas," Children and Youth Services Review, Elsevier, vol. 76(C), pages 213-226.
    17. Hernandez, Elaine M., 2013. "Provider and patient influences on the formation of socioeconomic health behavior disparities among pregnant women," Social Science & Medicine, Elsevier, vol. 82(C), pages 35-42.
    18. Garcia, Antonio R. & Circo, Elizabeth & DeNard, Christina & Hernandez, Natalie, 2015. "Barriers and facilitators to delivering effective mental health practice strategies for youth and families served by the child welfare system," Children and Youth Services Review, Elsevier, vol. 52(C), pages 110-122.
    19. Amitabh Chandra & Douglas O. Staiger, 2010. "Identifying Provider Prejudice in Healthcare," NBER Working Papers 16382, National Bureau of Economic Research, Inc.
    20. Finno-Velasquez, Megan, 2013. "The relationship between parent immigration status and concrete support service use among Latinos in child welfare: Findings using the National Survey of Child and Adolescent Well-being (NSCAWII)," Children and Youth Services Review, Elsevier, vol. 35(12), pages 2118-2127.
    21. Aaron Baugh & Reginald F. Baugh, 2020. "Assessment of Diversity Outcomes in American Medical School Admissions: Applying the Grutter Legitimacy Principles," Sustainability, MDPI, vol. 12(12), pages 1-17, June.
    22. Max-Louis G Buot & Jeffrey P Docena & Brenda K Ratemo & Matthew J Bittner & Jacob T Burlew & Aziz R Nuritdinov & Jennifer R Robbins, 2014. "Beyond Race and Place: Distal Sociological Determinants of HIV Disparities," PLOS ONE, Public Library of Science, vol. 9(4), pages 1-15, April.
    23. Khosla, Natalia N. & Perry, Sylvia P. & Moss-Racusin, Corinne A. & Burke, Sara E. & Dovidio, John F., 2018. "A comparison of clinicians' racial biases in the United States and France," Social Science & Medicine, Elsevier, vol. 206(C), pages 31-37.
    24. Lutfey, Karen E. & Link, Carol L. & Grant, Richard W. & Marceau, Lisa D. & McKinlay, John B., 2009. "Is certainty more important than diagnosis for understanding race and gender disparities?: An experiment using coronary heart disease and depression case vignettes," Health Policy, Elsevier, vol. 89(3), pages 279-287, March.
    25. Rose, Roderick A. & Parish, Susan L. & Yoo, Joan & Grady, Melissa D. & Powell, Sarah E. & Hicks-Sangster, Tamara K., 2010. "Suppression of racial disparities for children with special health care needs among families receiving Medicaid," Social Science & Medicine, Elsevier, vol. 70(9), pages 1263-1270, May.

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